While school nurses provide care and case management
services to millions of children, many more
students may receive access to care if federal health
reform dollars materialize to boost school nurseto-
student ratios. To prepare for this possible
eventuality—or to improve school nursing services
should the status quo remain—it is important to understand
which populations most use school nurse
services, to what extent, and for what reasons. Such
information may help to inform and improve new and
existing school health policies and programs.
Previous research has attempted to explain the
reasons for different populations’ use of school nurse
services by using aggregated data (Blake, Ledsky,
Goodenow, & O’Donnell, 2001; Schainker, O’Brien,
Fox, & Bauchner, 2005). The authors of these studies
suggested that individual-level data be analyzed in
future studies to improve validity in linking student
demographic data to usage patterns. That is what this
research does: it enumerates and analyzes individuallevel
data on students’ use of school nurse services
according to poverty, race, and ethnicity.
When this study was conducted in 2007 and
2008, the most recent data available for analyses were
for the 2005–2006 school year. All visits (n551,767)
to school nurses by middle and high school students
(n512,797) were collected and analyzed according to
ethnicity and poverty, both separately and together,
to determine whether and to what extent these characteristics
were associated with usage frequency and
quality.